September 1, 2006

Did you know some women use a device that pumps out their breastmilk while they are driving? That seems so wrong. But what do you think of all these other efforts women make to keep up with breastfeeding when they are separated from their babies? From my own experience with breastfeeding, I can't imagine wanting to keep it up once I'd gone back to work. The idea of using a mechanical pump is so unpleasant, and the milk seems too intimate to leave in the office refrigerator. (The picture at the link shows bags of milk -- cutesily labelled "My Mommy's Milk" -- on a freezer rack next to a box of black bean enchiladas.) And there's a huge problem -- not mentioned in the article -- that I'll just sum up in one word: leakage.

But apparently, a lot of women are working and pumping these days. I guess if you don't now, you're supposed to feel bad. It's hard enough to be a working mother without having people upping the standard of what it takes to do it passably well.

But as for the women who want to do it... they'd like more active accommodation by their employers. In pursuit of this goal, the linked NYT article takes the equality tack: Professional women are nicely accommodated by employers who offer posh "lactation rooms" and lots of time but working class women are stuck using the bathroom during their regular breaks. Are you softened up for some legislation yet?

[F]ederal law offers no protection to mothers who express milk on the job — despite the efforts of Representative Carolyn B. Maloney, Democrat of New York, who has introduced such legislation. “I can’t understand why this doesn’t move,” she said. “This is pro-family, pro-health, pro-economy.”

Meanwhile, states are stepping in. Twelve states have passed laws protecting pumping mothers — Oklahoma’s law, the newest, will take effect in November. But like Oklahoma’s, which merely states that an employer “may provide reasonable break time” and “may make a reasonable effort” to provide privacy, most are merely symbolic.

One solution that's not mentioned is giving women longer maternity leaves so they can breastfeed the baby directly. But that, ironically, would violate the Equal Protection Clause! Maternity leaves in excess of the pregnancy disability period of eight weeks -- unless an equal period is given to new fathers -- is unconstitutional sex discrimination. That's the plain implication of the Supreme Court's opinion in Nevada v. Hibbs -- upholding the Family and Medical Leave Act as an exercise of Congress's Fourteenth Amendment power -- as I pointed out in a law review article (PDF):

There was no recognition in Hibbs that a state might, without engaging in mere sex stereotypes, genuinely think that more than eight weeks are needed to recover from pregnancy and childbirth or might, quite apart from stereotypes about who ought to take care of a baby, want to facilitate breast-feeding for a period longer than eight weeks.

[FOOTNOTE} See Liz Galst, Babies Aren’t the Only Beneficiaries of Breast-Feeding, N.Y. TIMES, June 22, 2003, § 15, at 4 (noting the developing scientific evidence indicating that breastfeeding offers greater health benefits to children as well as to mothers). It is puzzling that there is no mention in the briefs or in the opinions of the issue of breast-feeding, which entails a real physical difference that can justify treating new mothers differently from fathers. The importance of accommodating breast-feeding women in the workplace should not make it seem invidious to support a new mother who wants to take a longer leave to procure this health benefit for herself and the infant, instead of struggling with breast-pumping or bringing the infant into the workplace. That medical research is developing in this area suggests the value of leaving room for experimentation with maternal leave policies.

When I was writing that article, I asked a colleague why no one brought up breastfeeding. She didn't have any ideas about why the states wouldn't use breastfeeding to account for treating men and women differently when it comes to giving leave to new parents (a key issue in Hibbs). But, she said, women's groups have not worked for breastfeeding leaves because it runs counter to their goal of pushing for requiring employers to accommodate breastfeeding employees. And, I would add, it conflicts with a preference for keeping women in the workplace. If a state offered more new parent leave to women in order to breastfeed, women's groups might construe it as an attempt to promote traditional sex roles, with the woman staying home with the baby. Can you tell the difference between a benefit and discrimination there? [ADDED: I should clarify that only government action violates the Equal Protection Clause, so that if the state is not the employer and if the new statutory law did not require longer leave for women, it would be possible to redo the statutory law that limits private employers.]

I think we could support giving women more of a choice whether to stay home and breastfeed or go back to work and continue to breastfeed. There is so much pressure on women! It's hard to go through pregnancy and childbirth and to take care of an infant. Breastfeeding a pretty simple part of this if you have your baby close by. But you may need to go back to work or want to go back to work. I strongly support that. And I support the pumping approach if you can do it. And of course the employer should accommodate the physical needs you will have. But it's a much harder question whether there should be laws that allow you to sue if you think your employer hasn't helped you enough. But of all the things we ought to do to make life easier for mothers, we should quit making them feel like they have to go through the pumping routine. It's hard to work and have an infant at home. It's going to be harder if you have to pump breastmilk throughout the day while you're trying to pay attention to your work -- regardless of how accommodating the employer is. Frankly, quite aside from the pumping task, I would not want to have to try to concentrate on work with my breasts acting up continually.

Now, before you pile on in the comments, let me restate my point. I think it's fine and admirable for women to pump breastmilk in the workplace, and employers should voluntarily accommodate them, but legislation may not be needed, we shouldn't put pressure on women to keep up breastfeeding when they go back to work, and women who decide they don't want to do it should feel perfectly justified in their decision.

68 comments:

That photo creeps me out -- why are there two days' worth of milk there? Does she store her breast milk in the company freezer? Eew. When the better half pumped at work (in her office), the stuff came home every day.

I'm not sure why anyone would pump in a car. On the way to work, you'd be freshly depleted, I would think. And on the way home, you're about to me latched on to! I wonder if you can pump, talk on the phone, change the radio station, and merge into traffic all at the same time.

doesn't really address the issue, but it is a true story. A few years ago an engineer friend worked for one of the large baby product companies. He did lots of prototyping with plastic components. He did some design work on breast pumps and they'd test out the suction by trying out various body parts; the elbow was a popular one, so was the shoulder. They were very excited when the department finally hired a female engineer.

So if women complain that products made specifically for them just aren't right, it's probably because the designers and engineers are almost always men. Best intentions and all that, but one of the guiding principles of maleness is "more power is always better."

I had to return to work 8 weeks after having my son because I worked for a very small agency who couldn't afford for me to be gone for 3 months. I had planned on pumping until my son was a year, and I barely made it to 6 months! It is a HUGE pain to pump at work--and my place was very accomodating.

I was lucky. In our building, there was a vacant office I could use to pump; if there hadn't been I would have had to use the bathroom which would have been uncomfortable and gross. But come on, someone wants to pass a law??? What does that mean, I would have "had the right" to kick someone out of their office three times a day to pump? Please!

I can understand why some childless people get annoyed by parents if they start making stupid demands like this. You are expecting everyone to accomodate what is an optional lifestyle choice you have made. Your baby is not going to die if he has formula.

(I always stored my miilk in a cooler, I felt weird having my bottles of breast milk in there with everyone's lunch!)

I have two kids and I took off 3 months with each but breastfed for 6 months. Pumping was no big deal - 10 to 15 minutes, once or twice during the day, milk stored in a bottle in a brown paper bag without any cute label, to be taken home at the end of the day. The electric pumps are very fast ("double barreled," to do both sides at once) and I had a spare office to use. All I needed was a few minutes of privacy and an electrical outlet (no mood music or loungy chair).

This was way back in the mid 80s and it was no big deal to me or any of my co-workers, so far as I could tell.

I'm a guy who works in a medium sized office room with 7 cubicles in it. The cubicles are set up for maximum privacy. A woman I don't know from another department was moved into a spare cubicle.

A few days later we heard this...noise. A weezing little motor noise. We all made jokes over on our side of the room ("Are they doing construction downstairs?" "I feel like I'm at the Dentists!") until someone clued us in that the new office-mate was using a breast pump at her desk.

I was immediately embarassed about my joking. But I never went over there to see what was going on with this woman. So I don't know if visually this was a bizarre thing to do, but I certainly have no problem with the idea of it.

And a few days later she got a new pump that doesn't make any noise at all.

This is the kind of farcical, no-win situation that we conservatives love to laugh at. Denying biology generally leads to tragicomedy.

Personally, I think nursing women should just be given the option of a one-year, unpaid leave. Finding a temporary replacement shouldn't be a problem for most jobs - generally, pregnancies have at least 7-8 months of advance warning - so, what's the problem?

And for jobs that require constant vigilance, with no easy replacement (say, defence contractor test engineer) than you should be thinking hard about having a child in the first place. Sometimes two activities are simply mutually exclusive.

Breast Pads! Our Yorkie retrieved one of these wayward pads that fell to the floor during a feeding frenzy one evening in a back bedroom, courtesy of a new mother who was visiting. I thought it was one of my wifes face pads she uses to cleanse her face with some magic elixir from estee lauder.

The horrified look on the young mother with the obvious wet spot gazing on the yorkie who was busily shaking the errant pad was hysterical.

we shouldn't put pressure on women to keep up breastfeeding when they go back to work, and women who decide they don't want to do it should feel perfectly justified in their decision.

This is so wrong. Of course we should pressure women to breastfeed, whether they are working or not, just like we should pressure smokers to quit. It's a matter of public health; we're all better off that way.

When I nursed my daughter, now nearly 8 years old, I used an Avent Isis pump. It was inexpensive, lightweight, easy to use, and super-efficient. I can only imagine that they've continued to improve the design and efficiency over the years.

Another area where technology is making breastfeeding easier is breast pads. The disposable ones were absorbent and comfortable when I used them all those years ago. The leaking was worst with my oldest, but I didn't really leak very long with my younger two. There are little tricks you learn to stave it off.

My youngest is just five but it's weird to think about those years of nursing and diapers and all that. It seems interminable when you're in it, but then it's over.

CriticalObserver: that was sarcasm, right? Just in case it wasn't, there's a difference between encouraging and supporting breastfeeding, and pressuring already maxed-out women. And there's a huge difference between not smoking and breastfeeding.

Ann,Your post is right on. I guess this is one reason I'm so irritated with the women's movement. Absolutely loads of evidence shows that breastfeeding benefits the baby and the mother--mothers enjoy reduced risk of cancer, diabetes, alzheimers. Just about any bad health thing you can imagine is significantly reduced simply by breastfeeding one year.

Women are forced to feel "less than" if they don't go back to work right away or if they stay home to care for their child and "sell out". What the? And the double-bind is often imposed by women.

A word to some men commenting here:every stray negative thought you've ever had about allowing a discreet space for nursing mothers to pump in the workplace so they can "train" their breasts to keep functioning after hours - every awkward, silly, furtive, mortified, self-conscious, strange, non-PC, childish, inexplicably hostile, even superficially reasonable etc etc thought - guess what?

The newly working, nursing mother will have self-humiliatingly turned them all over first - in her own mind.

I think Ann has the 'voluntary accommodation' line about right.

But because most women are NOT La Leche warriors, the "voluntary" and "accomodation" bits need to be generous.

Just in case it wasn't, there's a difference between encouraging and supporting breastfeeding, and pressuring already maxed-out women. And there's a huge difference between not smoking and breastfeeding.

This is wrong. There is no difference between promoting breastfeeding and "pressuring women to breastfeed" because anytime you promote breastfeeding, women who refuse to heed the wisdom of the advice will complain you're "pressuring" (or "oppressing") them.

And, there is no relevant distinction between smoking and not-breastfeeding -- not-breastfeeding promotes a hands-off, irresponsible attitude toward motherhood, harms the babies, harms the community in which those babies grow up and are likelier to commit crimes, and harms the public school system, where all the breastfed kids have to contend with the non-breastfed idiots who can't add as fast.

As for the difference between not-smoking and breastfeeding, breastfeeding is of greater value to the society than not-smoking; the absence of breastfeeding is a greater harm than the absence of not-smoking.

Maybe if I'd been breastfed longer I could spell "accommodation" correctly -

Actually, given how much DHEA secretion breast-milk encourages, and given its positive effect on cerebral cortex development, that's probably true. On average non-breastfed babies have an IQ 8.33 points lower. Given that the average IQ is 100; yes, being down in the 90s would put you in the "functional, but a bit dumb" range.

Isn't it possible that some women continue pumping at work because they want to? After reading the article's opening paragraph and some of the comments, I think it's unfortunate that women who want to continue pumping breastmilk for their babies are lumped into the same category with the "La Leche Police."

Many women feel that by pumping at work they are doing the best they can for a baby who is at home or at childcare. Also, if a woman needs to work because she cannot afford to stay home, breastfeeding is also a much more economical choice than formula feeding. A good breast pump can cost up to $300, but formula for a year costs much much more than that.

Sure there are some people out there who are pushing a pro-breastfeeding agenda, but not everyone who breastfeeds is judgemental and critical of others. However, I think the beginning of your post does nothing but continue that stereotype.

Cat said... Bill, I don't understand - why did they use an elbow when men have nipples too? Just askin'

The male breast area is usually a much flatter surface than the females. So the elbow made a better protuberance than the male nipple. This was in the early stages of R&D and not directly to ready to ship.

OK, I'm rapidly getting too into tangential topics. But the image of somebody trying to use a breast pump while driving reminds me that a friends of mine who worked at a toll booth once commented to me in apparent seriousness that the weirdest thing about his job was that at least once a day some woman would, after paying her toll, expose herself to him and drive away. There's something about toll-takers anyway, I guess: you always so desperately try to be nice to them, want them to like you. But anyway. I imagine if they're all going through the toll with their breast pumps going now that's easier to deal with...

CriticalObserver, It is clear you are neither a woman, nor a parent. Has it even occured to you that not all mother have a CHOICE in this whole situation that's being discussed?

There are women who desperatly want to breastfeed but cannot (because of health issues, physical issues, baby's health issues, etc), there are women who are not fond of breastfeeding but have babies who cannot tolerate formula. There are single women who have no choice but to return to work as soon as their paid leave is up.

I agree that breastmilk is generally the best thing for an infant, but it's not always feasible, so constantly shoving it in womens' faces is totally unnecessary. I doubt there is a woman alive in the U.S. of child-baring age who doesn't know breastmilk is better for babies.

Instead of accusing people who care about public health of being latent porn-addicts or throwing up the spectre of jailing mommies, why not simply give out a tax credit to mothers who do?

For the love of all that is holy, no. How would you enforce this? Send inspectors to every house? The nanny state is quite overbearing enough, without become the literal nanny state.

As much as I think feminism (in its current state) hurts women and children, it's their choice. There are obvious and substantial medical benefits to breast-feeding, that is beyond doubt. But if mothers choose not too, that's their choice. We don't regulate smoking/drinking during pregnancy, we shouldn't regulate this either.

If the kids turn out bad, the criminal justice system can bring down the hammer.

I nursed each of my three children for a year; they weaned themselves at that point. My experience of nursing my children informed my comment.

I think it's hysterical that you'll extend an estimated difference in IQ of 8 points between breast-fed and bottle-fed babies all the way to calling bottle-fed children "tardos", which can only be some riff on "retarded." If you're a baby boomer born in America, chances are you were bottle fed. Are we an entire generation of "tardos"? I hadn't noticed.

I agree with Amy: breast-feeding is best, but there is no reason to demonize women who are unable to breast feed their infants.

One of my friends is writing a dissertation about a breastfeeding case in the 1970s. A woman firefighter was fired for breastfeeding her baby at work. The case got some national coverage.

Anyways - I know feminist legal scholars who do not see a conflict between equal protection and maternity leave for maternity (breast feeding/ the after math of pregnancy & labor/ ect.)

It's a recognition of bodily difference -- just as health insurance policies must cover pregnancy, even though men can never get pregnant. Is that gender discrimination? No. It's simply a bodily difference.

Breastfeeding falls in the same category. Thus an enlargement of the social contract to include the protection of a new mother's job, say for a year, does not discriminate against men if it's for the purpose of breastfeeding/bodily difference.

Anyways -- it's too bad that pregnancy, and childbirth, and the duties surrounding them, such as breast feeding are so much more difficult in the US then in other countries. (Australia/ France/ Germany, New Zealand ect.) It's a time that should be filled with such joy - but it is quite naturally difficult, and our national policies encourage stressful situations, such as going back to work after only 8 weeks.

It causes unnecessary stress to new families, to babies, to mothers, to fathers -- really, it's just sad.

If you're a baby boomer born in America, chances are you were bottle fed. Are we an entire generation of "tardos"? I hadn't noticed.

You haven't noticed because you're a tardo. And you're willing to make your grandkids slave away for your Social Security check because you're a tardo. And the difference between a 100 IQ and 92 IQ, on average, is the difference between the absence of and the presence of mild retardation. What if you're the mother whose child suffers a 20 point drop because of no breast-milk? When is it tardo enough for you? 90 IQ? 80? 70? At what level of IQ are you willing to recognize retardation? Moron? Idiot? You should be fined.

What if I used my tax credit to buy gin to relax my nerves enough to use a breast pump in a sexist working environment?

If you think your work environment is sexist because other people don't want to see pumps you attach to body parts that provide sexual gratification, then you're too stupid to understand what a tax credit is.

For the love of all that is holy, no. How would you enforce this? Send inspectors to every house?

Apparently, I was right -- you non-breastfed tardos don't know what tax credits are. You get the credit if you show that you've been breastfeeding. How? You check a box on your, uh-duh, tax return, durrr. But what if people cheat? says the tardo. They get the same treatment other people who cheat do. We audit people randomly and if they lied, it's fraud and they can be charged.

I agree with Amy: breast-feeding is best, but there is no reason to demonize women who are unable to breast feed their infants.

I guess, by this logic, you support the invasion of Iraq. Going to war on verifiable informaton that WMDs exist in Country X is best, but there is no reason to demonize Presidents who are unable to secure verifiable information that WMDs exist in Country X before going to war.

"Yeah, and mothers who refuse to breastfeed their kids are assholes, too. What happened to your hatred of breeders? I guess it only extends to men."

Well, now we know that you're a bottle-fed retardo too. It's downtownlad that hates "breeders". Repeat after me: d-o-w-n-t-o-w-n-l-a-d different than P-a-l-l-a-d-i-a-n. I know it's hard to tell people apart sometimes, being that it requires a higher, breast-based level of intelligence.

It's not that breasts set me off. It's that I oppose inadvertantly creating an army of retard criminals running rampant in the streets. And, you are also, apparently, confused about my gender. I would suggest you check some older posts.

By the way - I think I mis-stated the argument I heard from the legal scholars. (I'm not a legal scholar :)

But I attended a lecture that discussed how to approach the equal protection issue, yet protect and accommodate bodily difference. Pregnancy, labor and breast feeding were particularly discussed in this lecture.-------------------This approach was something like this:

All humans should have the right and the space to pump (or breast feed) at work.

All men who can pump milk are included in this group. They may take breaks and go in a lactation room or pull out a pump to pump milk if for some reason the, uh, develop this ability.

So it's a discrimination of bodily difference, but not gender. Just as it's not gender discrimination to accomodate a woman for, say, needing sick leave or health insurance coverage because of breast cancer or uterine cancer.

Back when I lived in the city, I was taking the bus and I overheard a conversation between two young women of color. One was obviously a woman of gravidity. From what I could tell, neither of them were women of affluence.

Anyway, they were discussing child care and they both agreed they would never breast feed their children because it would make their breasts sag and make them less sexually attractive to men.

Shortly thereafter, I went to see my G.P. at a heath clinic near a public housing project and I asked him why there were boxes and boxes of baby formula stacked up in the waiting room. He said it was part of a community outreach program or something like that.

I mentioned the saggy breast conversation. He said that point of view was widespread among inner-city woman. He also said it was of little concern to the clinic why women chose not to breast feed. He said it was more important that the formula be made available.

I don't know why I even get involved. But, for the benefit of anyone who may come across this page in the future:

The benefits of breastfeeding on children's intelligence are nowhere near as clear-cut as CriticalObserver posts above.

Recent research on the topic, easily findable through PubMed, includes:

* Clark, et. al, Ambul Pediatrics, 2006 Mar-Apr, "Breastfeeding and mental and motor development at 5 1/2 years", concludes that breast-feeding as the sole milk source for some ages is associated with poorer cognitive and motor development* Slykerman, et. al, Acta Paediatr., 2005 Jul, "Breastfeeding and intelligence of preschool children", finds no significant correlation except for children that are small for their gestational age (that's low-birth-weight children)* Smith MM et. al, Am. J. Epidemiology, 2003 Dec, "Influence of breastfeeding on cognitive outcomes at age 6-8 years; follow-up of very low birth-weight infants", found positive effects across the board for breast-fed children, but once they controlled for home environment, the mother's verbal ability and education, and length of hospitalization, the only positive effect left was for visual-motor integration.

First, the association between breast-feeding and intelligence is not necessarily a causal connection; it could be that women who breastfeed are generally the the type of women who do other things than contribute to their children's intelligence, such as read to them.

Second, there are millions if not billions of law-abiding, intelligent people who were bottle-fed.

Third, I think there is too much judgment of choices that people make, and also too much emphasis on polarity (either you breastfeed or you don't).

In fact, I had two children & breast fed them both while working. I simply breastfed them before I left for work and while I was with them after I got home and on week-ends. My milk supply was fine. The children thrived.

If you believe we should regulate smoking and such during pregnancy, obviously you are not libertarian. In which case, further discussion is pointless - we have far more fundamental disagreements.

But on the point of tax credits to breastfeeding, and your suggestion to audit, that is patently ridiculous. Auditing financial records requires little more than a few phone calls to relevant financial institutions. How do you propose to "audit" breastfeeding? Interview the baby? Squeeze and check for lactation?

Joan:

It's interesting that you had a A- GPA, given that MIT does not give out +/- modifiers, and has no accepted system for converting numerical GPA to A+/A/A-, for example.

Please do not take Critical Observer seriously or respond to his increasingly ridiculous posts.

As for breastfeeding, I am a wholehearted proponent. Not really sure how I'll manage it, maybe have hubby bring the baby to the office at lunch? Or would the car ride every day be so dangerous as to outweigh the benefits? Maybe we should buy a condo downtown so I can go home for lunch? All that assuming I actually can breastfeed, outlasting the pain, chapped nipples, mastitis, etc. Really too much to worry about -- we'll just have to see what comes naturally. The mommy guilt in the country is out of contol!!!!

Altoids: give me a break, will you? My GPA was 4.7. I didn't give the number because MIT's 5-point scale inevitably causes confusion. But in any rational world, 4.7/5.0 is at least an A-, if not an outright A. Shall I post my transcript for you? Will you then get on my case about the fact that freshmen don't get letter grades at all, that everything you take freshman year is pass/fail? Please, let's not. I knew it was stupid to try and demonstrate that I am not a "tardo", but now I can see how engaging in this conversation could support the idea that, perhaps in some areas, I am.